Throughout my years working in psychiatry, the magic word that indicated “success” either in inpatient or outpatient settings was “stability” or “stable”. During my time working as a registered nurse in a hospital-based psychiatric unit, the discharge note would inevitably note something along the lines as, “the patient has achieved stability…the patient is now stable…the patient notes they feel stable…and they are now fit to be discharged. During my years as a nurse practitioner, I would catch myself ending my note stating, “the patient reports stability…no further changes need to be made”.
Can we ponder what being stable actually means for a moment? How have we defined it over the years in conventional psychiatry? Does it mean the patient is no longer suicidal? No longer psychotic? No longer having panic attacks? When they can follow a conversation without being distracted? How much does our personal bias as providers influence what we feel is actually “stable”? What is the actual rubric by which we define this?
Does it matter that a patient may be returning to the same environment that may have led to instability in the first place? Can we really claim a patient is “stable” when they have a myriad of chronic health problems? What about poor diet or a lack of physical activity?
The mechanism by which conventional psychiatry seeks “stability” is primary via pharmaceuticals. I want to state again that in some cases when there is imminent need, medications can be powerful tools to regain a client’s sense of control and awareness. That said, they are tools and in my opinion fall short of being solutions. It is important that we recognize that while medications may allay symptoms, they certainly do not guarantee “stability”.
Perhaps you have been on psychiatric medications and have been through the trial and error process. Perhaps you have had the experience when you started with one medication and then needed to add another or yet another to counter possible side effects or because there was a sense that symptoms were not yet adequately controlled. It can be a frustrating and confusing process sometimes made much worse by side effects.
I have prescribed a lot of medications over the years. If it all goes well, patients often come back feeling pleased with the results, but it is rare that this feeling sustains itself. Perhaps months later they may say, “I don’t think this medication is working anymore…” or “I am concerned about side effects.” I have learned that it is unrealistic to assume that “stability” can continue in the midst of chronic disease, chronic stress, contentious relationships, social isolation, and/or socioeconomic limitations.
Now it is time for a bit of imagery.
Picture yourself sailing in a boat in the water. There are multiple small holes in the boat. You have a bucket and are able to throw water overboard allowing the boat to stay afloat for a while longer. Yet, the holes still remain and at some point you are going to become exhausted from trying to stay afloat. A medication may be a bucket for a while, but often does not address the foundational problem.
I have not come across a medication that seals all the holes in your boat.
This is why I have become passionate about functional medicine. Functional medicine is looking for the holes in your boat. We might give you a bucket from time to time, but the goal is to seal the holes and even better, just give you a new, stronger boat that withstands the rough waters. This is the basis of vitality- when you can function with resilience and “sail” or per our namesake, “SOAR” to your full potential.
At She Soars Psychiatry, LLC we take a close look at all factors including cellular health, immune function, inflammation, organ health, gastrointestinal health, nutrition, physical activity, psychosocial, and psycho-spiritual. When these factors go awry they can cause “holes in your boat” leading to emotional imbalances. We aim to restore not just stability, but vitality.
Everyone feels like they are sinking from time to time. Life happens. Resilience can be strengthened however. We look forward to helping you stay strong and afloat as there are certainly rough waters to navigate out there. Happy sailing!
To learn more about functional medicine, please visit The Institute for Functional Medicine.
To schedule an appointment with us call 541-595-8337 or visit www.shesoarpsych.com
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Audry Van Houweling, PMHNP-BC, HNFM certified, DONA trained postpartum doula, Owner & Founder, She Soars Psychiatry, LLC